Briefing on the science and policy of e-cigarettes and vaping

Welcome to this briefing on e-cigarettes, vaping and public health: a summary for policymakers – now with translations in French and German. Here is the table of contents:

Version 3 Updated 27 February 2015

Intended users. This briefing has been produced to assist consumers, businesses, public health advocates and open-minded researchers in understanding and communicating the science and policy issues arising from e-cigarettes and vaping. It takes a positive but evidence-based approach to vaping and ‘tobacco harm reduction’.

Intended use. I hope it will be used to persuade law-makers, regulators, media and public health to taken an enlightened approach to these innovations. If you wish to use this for advocacy purposes, you do not need permission – the PDF is freely available, though I welcome feedback if you are using it.

Authorship: If you do use this to create your own briefing, I would be grateful for acknowledgement and a link back to this page. If you wish to modify this and list me as a co-author, I will need to see and agree to any final text.

Feedback: I hope you find this useful. Please provide feedback, especially if there is anything you find wrong or unsatisfactory or where there is scope for improvement and please make suggestions for future versions. Please use comments below to comment publicly or the contact form to contact me directly.

[…] of organisers and candidates, say thank you graciously to the organisers and give the candidates Clive Bates’ briefing. Tell them to read it! The UKIP candidate tells me he’s not had a fag for 4 weeks and has an […]

I’d like to submit this to the South Australian Government. They are establishing a Select Committee to investigate & report on health & regulatory issues of e-cigarettes. This is in addition to the Federal Government doing a similar thing which is still not resolved.

Is it OK if I submit it in it’s original form with no alterations. All I’d be doing is providing a covering document which will reference local issues specific to Australia.

Furthermore, the lead author admitted in a response to a comment that the results possibly attributable to nicotine alone, “my guess is that nicotine is a significant contributor to the altered immune response, but there could be other components as well.”http://www.plosone.org/annotation/listThread.action?root=85423

The effects of nicotine on immunity in humans are certainly not significant to show in NRT RCTs, and they certainly don’t have a significant effect on all-cause-mortality of SLT users. This is in addition for other suggestive evidence cited by Mayer that nicotine doesn’t have the same effects on humans.

[…] The Committee commendably took evidence from a range of experts covering the full spectrum of views about vaping and tobacco harm reduction, and has summarised the divisions of opinion quite well. A close reading reveals the weakness of the opponents of harm reduction and vaping and the strength of evidence presented by the pro-harm reduction witnesses. I submitted written evidence: A disruptive public health technology threatened by excessive regulation (this has since evolved into my more comprehensive briefing). […]

No, it’s correct. It refers to tobacco regulation, which is designed to prevent innovation or proliferation of tobacco cigarette products. The point is that this law has no relevance to non-tobacco products such as ecigs.

Hello Clive
Sorry for my poor english writting but i am a french vaper too:)
First and foremost, i would like to thank you for your well-documented article.

But i have to react about what you wrote about the DIY….
I quote : “There is significant risk that loss of broad flavour categories will cause relapse among e-cigarette users, fewer smokers switching, and development of DIY and black market flavours – which may be more dangerous”
I really do not understand why DIY may be “more dangerous”. More dangerous than??
My home-made e-liquids are safe (even safer than some commercialy-purchased liquids !), but i must confess that there are harmful to Big Tobacco and Big Shops :)
Doing one’s own e-liquid is not like making a black market! Black marked (one of the TPD’s consequences) is a threat but DIY is not a threat for people’s health.
To get rid of cigarette addiction, DIY is more efficient than commercialy-purchased liquids because it is less expansive (smokers are “poor” because of cigarettes price) and allows to decrease the rate of nicotine more gradually.
In France, regulation means rules and prohibition !
Vaping is not only a market, it is the best way to protect smokers’ health ! The cheaper vaping is, the more efficient it is to fight against tobacco addiction!
Best regards
A vaper from France

I also do not understand the expression : “development of DIY” because TDP is aimed to threaten the pratice of DIY by prohibiting the nicotined-e-liquid sale in bottles over 10 ml , as well as more than 20 mg / ml.

But DIY is not only a consequence of regulation. DIY is also the result of :

– Need to have a best economic approach (Tobacco costed us 400 euro / month, “classic” vape made it 80 euro per month, DIY then made it 20 euro per month … for 2 vapers). That means 720 euro per year between classic and diy …

– Need to keep an absolute control about the content. Of course we have no control about flavors contents wich is in my mind the only critical point (specially with natural flavor). So what has to be more regulated is not DIY which is not a danger but only flavors have to be regulated.

– Need flexibility about nicotine % and / or flavor density and / or PG-VG %.

And what is good for the earth : DIY is very ecologic (no plastic bootles in the trash …) ;)

It is for all these reasons that i have been hurted to see DIY and Black market putted on the same plan …

Anyway, I note that : “I personally have no objection to DIY – I would hope a lightly regulated consumer focussed market would make it largely unnecessary. But if it helps some people stay in vaping then any risks are worth accepting.” …

I am sorry but i do not agree with you at all about DIY … You wrote that DIY is for you a DANGER like black market is a DANGER !

No no no 1000 times no !

DIY is the best way (the only one ? )to keep smokers and vapers far away from all nefast and addictive products that Big Tobacco will put in the future in e-liquide or locked caps from cigalike. The best way because with diy, vapers keep the control about the contents.

I totally respect all what you do for Vape but on this point i think you are wrong.

I raise the point about DIY because it is likely to be an unintended self-defeating consequence of over zealous regulation, and therefore from the perspective of the regulator it provides a limit on how burdensome their regulation can be before consumers defect and do their own thing. The European Commission, FDA etc need to consider this seriously: pretending that you have a highly regulated market when many people simply ‘defect’ and avoid the regulated products is just poor regulatory practice.

I personally have no objection to DIY – I would hope a lightly regulated consumer focussed market would make it largely unnecessary. But if it helps some people stay in vaping then any risks are worth accepting.

I have the same view of the black market – I am glad that Canadians and Australians have access to much safer ways to take nicotine than smoking, despite the efforts of their public health advocates and regulators to reserve the nicotine market for the cigarette trade.

[…] a system of bonded warehouses and weights and measures officials charging taxes. Please read this Summary for Policymakers on science and policy aspects of e-cigarettes and vaping before having any further […]

Thank you posting this useful information and actively posting content regarding e-cigarettes :) I have recently created a website to encourage more people to give up smoking and make finding ecig and vaping shops more accessible in the United Kingdom at http://www.ecigdirectory.co.uk – hope you don’t mind me posting the link.

[…] Briefing on the science and policy of e-cigarettes and vaping (Clive Bates) Welcome to this briefing on e-cigarettes, vaping and public health: a summary for policymakers. Here is the table of contents: ………………… read on. This may be quite useful. European Vapers: We need you! Please sign the European Free Vaping Initiative – for all of us! Reply With Quote […]

The chart on page 11 (3.2.3 Gateway effects) should be printed and carried by any and EVERYone who has to fight the “gateway effect” argument among the public. Thank you so much for making this accessible and useable!!!!

At the top of page 8, in the first paragraph, the line ” There is a simple protective measure available: to insist on tamper resistant packaging, for which there is an ISO standard” appears to actually refer to child-resistant, rather than tamper-evident packaging. Tamper resistant packaging would presumably make it difficult for adult consumers to open, which might be unhelpful!